The following is a summary of “Co-Morbidity Differences Associated With Long-Term Amputation and Repeat Revascularization Rates After Femoropopliteal Artery Intervention for Intermittent Claudication by Sex, Race, and Ethnicity,” published in the June 2024 issue of Cardiology by Altin et al.

The use of peripheral vascular intervention (PVI) to treat intermittent claudication (IC) continues to expand. But it’s unclear if factors like sex, race, or ethnicity affect who gets the procedure or how well it works. 

Researchers conducted a retrospective study investigating amputation and revascularization rates up to 4 years after femoropopliteal (FP) PVI for IC, focusing on sex, race, and ethnicity. 

They studied data from a PINC AITM Healthcare Database (2016-2020) on patients who had FP PVI for IC. The primary outcome index, limb amputation (ILA), was assessed by Kaplan-Meier estimate, and secondary outcomes were index limb major amputation, repeat revascularization, and index limb repeat revascularization. The HR was estimated using Cox proportional hazard regression models.  

The results showed 19,324 patients with IC who underwent FP PVI were 41.2% women, 15.6% Black and 4.7% Hispanic. Women were less likely to get a specific procedure than men (45.1% vs. 47.8%, P=0.0003), and patients who were black were more likely than white patients to get an atherectomy (50.7% vs. 44.9%, P<0.001). Also, patients with Hispanic identity were less likely to receive atherectomy than their non-Hispanic counterparts (41% vs. 47%, P=0.0004). Amputation rates were similar for men and women (6.4 for each group, log-rank P=0.842). Higher among blacks (7.8% vs. 6.1%, log-rank P=0.007) and higher among Hispanic groups (8.8% vs. 6.3%, log-rank P=0.031). After adjusting for baseline characteristics, the Black race was observed to get more repeat revascularization (aHR=1.13, 95% CI: 1.04-1.22) and femoropopliteal revascularization (aHR=1.10, 95% CI: 1.01-1.20).

Investigators concluded that while treatment and amputation rates were similar for men and women, black patients needed repeat procedures more often. Racial disparities in initial treatment and revascularization need further investigation.

Source: ajconline.org/article/S0002-9149(24)00384-9/abstract